The Satcher Health Leadership Institute (SHLI) at Morehouse School of Medicine (MSM) is leading a Health Policy Transdisciplinary Collaborative Center (TCC) for Health Disparities Research, in collaboration with the Clinical Research Center, The Prevention Research Center and the National Center for Primary Care. The unifying theme of a comprehensive and meaningful approach to the development, advancement, and implementation of health policy that harnesses the power of collaboration to bolster innovation, cost reduction, and health equity. The SHLI TCC proposes transformative health policy goals that will positively impact and sustain health equity across our regional transdisciplinary collaborative, with the ultimate goal of the SHLI emerging as the preeminent, national health policy center focused on innovation, cost reduction and health equity; emerging as the 'collaborator of choice' in leading-edge health policy research focused on health equity; train the next generation of leaders in health policy research and expand the diversity of the health policy workforce. SHLI TCC and its partners across HHS Region IV, will significantly impact the health outcomes of participating communities through policy development and implementation.

Health360x is being implemented within the Morehouse Choice Accountable Care Organization as part of Centralized Care Coordination to improve self- management skills of high risk diabetic patients

PI: David Satcher, M.D., Ph.D.

2. NCRP Winter 2015 Strategically Focused Grant 15SFDRN239100

07/01/2015 – 06/30/2019

Disparities Research Network

American Heart Association

Biological and Socio-Cultural Determinants and Management of Cardiovascular Health Factors in Multi-ethnic Populations aka The MECA program

MECA will launch a novel multi-level investigation into the characteristics and the determinants of resilience among Blacks in the US as a source of insights that could yield effective approaches to reducing risk, disease and death. The fact that blacks are a high risk population is well documented; however, not all Blacks have poor CV health, and often have good health despite the ethnically-determined challenges to health and vigor. These facts attest to the existence of resilience within the Black population which is vastly underexplored. If successful, this work could be instrumental in moving from what we think can or should work in the Black community, to what actually does work for the Black Americans who are free of heart disease (more than 85% of blacks), free of diabetes(over 80%) free of high blood pressure(>50%).

Health360x is the technology that supports an investigation of effective strategies for using technology to engage blacks for improved self-management skills and overall health outcomes

PI: Herman Taylor, MD

3. NIH/NIMHD U54 MD007588

09/28/09 – 04/30/2019

RCMI Center of Excellence for Clinical and Translational Research (R-Center)

The major goal of this project is to improve the health of the underserved minority populations through clinical research development.

Health360x is in use as a resource to improve collection of patient reported outcomes; involvement of the Community in setting the research agenda and in building social networks for health equity

PI: Valerie Montgomery Rice, MD

4. NIH/NCATS UL1TR000454

09/17/2007-05/31/2017

Atlanta Clinical and Translational Science Institute

Atlanta Clinical and Translational Science Institute in response to a national effort, the Atlanta Clinical and Translational Science Institute created a partnership of Emory, Morehouse, Georgia Tech and other institutions to concentrate basic, translational, and clinical investigators, community clinicians, professional societies, and industry collaborators in dynamic programs and research projects. The major aims are discovery, training, and community engagement to create a new citywide home for clinical and translation research.

Health360x aka ehealthystrides was implemented in a church community, Big Bethel AME church and was successful in improving diabetes outcomes and self-management skills
PI: David Stephens, MD (Emory)

5. Microsoft Foundation

06/2009-06/2012

Integrated Patient Centered Model for Diabetes Care and Cardiovascular Disease Prevention (patent issued for a System and Method for Chronic illness Care)

The prototype for Health360x aka ehealthystrides was developed and tested in the Community Physicians’ Network practices

PI: Elizabeth Ofili, M.D., M.P.H., FACC

7. The Medtronic Foundation

2003-2006

Medtronic Clinical Cardiovascular Program
The Community Physicians Network (Network) is a quality and care improvement network organized in 2002, in order to extend MSM’s impact in quality health care delivery to Atlanta’s minority and multicultural community. With $1 million donation in 2003, the Medtronic Foundation selected MSM’s Community Physicians Network as the recipient of its largest single donation outside Minnesota: i) to develop an evidence-based practice among a consortium of member institutions through innovative educational strategies in primary care practices.

ii) to establish a clinical data repository to support practice-oriented health outcomes research critical to reducing cardiovascular disease related to health care disparities. Members of the Network serve majority African American and minority patients in their practices; The Network has grown to include 150 private practice physicians serving over 100,000 multi-plan recipients in metropolitan Atlanta, Macon, Augusta, Columbus and Albany Georgia, and partnering with MSM to deliver quality health care to Georgia’s minority communities. Network members commit to maintaining the highest standards of clinical practice by participating in NCQA certifications, innovative practice based research and continuing medical education programs. The 120 primary care member practices of the Network received the Agency for Healthcare, Research and Quality designation as a PBRN in 2010. 6,500 patients participate in other services of the Network, including clinical registries in hypertension, diabetes, and heart failure; 26 practices attained NCQA diabetes physician recognition (DPRP) in 2005. Over 2500 physicians across the state of Georgia have participated in the Network’s educational programs; 123 network physicians and study coordinators, including 61 new investigators have been trained in “Good Clinical Practice” for research. The Network’s Public-Private-Partnership programs have included the Bridges to Excellence pay for performance pilot program and the Georgia Diabetes and Obesity initiative which received a Proclamation from Georgia’s Governor Sonny Purdue in 2007. The Association of American Medical Colleges (AAMC) recommends the Network model as a “best practice” in academic community partnerships.

The Network has attracted over $10 million in peer reviewed collaborative NIH funding, including the Atlanta Clinical and Translational Science Institute, an innovative 3 institution partnership (Emory, MSM and Georgia Tech) that collaborates with Georgia’s health care and research institutions to accelerate the translation of scientific discovery to benefit patients. Network physicians participate in the community engagement program of the ACTSI, which is led by MSM. The MSM-Rochester research in comparative effectiveness (RICE), also funded by the NIH, is training Network physicians in the methodology of comparative effectiveness research, economic analysis and decision support.

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